Clapper, Patti, Schweizer and Mason

Mesothelioma is a deadly disease that strikes thousands of people worldwide.  A form of 'asbestos cancer,' it is invariably fatal and though it can be treated, there is no known cure.  Indeed, the disease itself is a bit of an enigma and very little is known about the exact mechanics of how mesothelioma causes death.  While many doctors suspect a mechanical component to the deadly disease (tumor growth impedes breathing and other necessary organ functions,) the methods through which the death occurs have never really been examined satisfactorily.

Operating on the assumption that if the method of death could be isolated, possible mesothelioma treatments could be developed to prolong life, researchers from the U.K. and Australia recently teamed up investigate post mortem data. 

They looked at post mortem reports of over 300 patients with confirmed mesothelioma diagnosis hoping to find concretely defined causes of death and/or any sort of patterns that might emerge. 

Mesothelioma is considered a locally invasive cancer.  While it can metastasize and travel to the lymph nodes and other portions of the body, it generally starts as a localized tumor, usually somewhere close to the lungs in the chest cavity (pleural mesothelioma) or near the digestive system in the abdomen (peritoneal mesothelioma.)  After diagnosis, the disease often progresses quickly, in part due to an extra-long latency period in which symptoms are not noticed until long after the tumors have developed.   By the time most patients realize anything is wrong, the cancer has reached stage III or stage IV and treatment options are more limited.

The study examined 169 coroner’s reports from Australia and 149 from Avon in order to collect a significant amount of data.  They discovered that over 91% of the mesothelioma patients were male between the ages of 56 and 79 years old.  Most of these pleural mesothelioma patients suffered tumor growth in or around the right lung – which is most common because the right lung is the largest and responsible for processing the majority of the air we breathe.

In 87% of these patients, the cancer was found to have travelled to the lymph nodes, making it nearly impossible to treat.  In addition, over 55% of patients had also experienced tumors elsewhere in the body other than the original cancer site.  Within this slight majority, patients were found to have mesothelioma cells in the liver, spleen, thyroid gland, and even the brain. 

As for direct cause of death, that was much harder to extract from the given data.  Thirteen of the patients had suffered pulmonary embolism shortly before passing which directly contributed to their deaths.  Indeed, respiratory ailments or decreased respiratory function are among the leading causes of death for mesothelioma patients.  Often tumors grow to a size that interferes with lung capacity or metabolic changes in the pleural fluid cause a hardening or encasing of the lung which reduces expansion. 

Another common cause is disruption of hepatic functioning, evidenced by the number of patients in the study who suffered tumor growth in and around the liver – roughly 30%.  The body is unable to clear toxins and they build in the bloodstream until they interfere with the functioning of other organs. 

However, in nearly 20% of the cases no concrete cause of death could be determined. 

Researchers did note that in those patients that no physical cause of death could be found, their body mass index was significantly lower.  This led the team to conclude that some sort of physiological and/or metabolic crisis had directly contributed to the patient’s death.

Even with all the data available to them, researchers were confronted with something of a puzzle.  The cause of death in many mesothelioma cases remains undetected.  However, the study did provide an important snapshot of the physical ailments that often contribute to the decline of mesothelioma patients. 

Source: Post Mortem Findings of Malignant Pleural Mesothelioma:  A Two-Centre Study of 318 Patients